Exercise for Breast Cancer Survivors

by Carole M. Schneider, PhD

Exercise is beneficial for breast
cancer survivors. In fact, you
should avoid inactivity, which
can add to your fatigue and make you
feel worse.

Exercise during and following your
treatment will make you less fatigued,
help you tolerate your treatment, help
you maintain your strength for daily activities,
improve your shoulder range
of motion, reduce your anxiety, and improve
your quality of life. You need to
allow yourself some time for upper-body
healing, but you should return to daily
activities as soon as possible. Begin
working the upper body with a trained
physical therapist who can teach you
basic range-of-motion and shouldermobility
exercises. At the same time,
since treatment affects your entire body,
you should exercise the lower body
during the healing process, either in a
supervised environment or with a homebased
walking program.

Building Your Own Exercise
Program
Your exercise program
should include variety and balance.
You can achieve this by ensuring you
focus on the main components of exercise:
frequency, duration, intensity,
and progression.

You should begin your program by
exercising more than once per day (2 to 3
times) for short periods (5 to 10 minutes)
followed by rest periods for a minimum
of three days per week. Once you can
tolerate short bouts, you may progress
to longer, continuous periods (30 to 45
minutes) of exercise two to four times
per week.

Weight training is especially beneficial for cancer survivors.

Dr. Carole Schneider

You should work out at a low intensity
to start. There are many ways to
determine how hard you should work out.
The easiest way is to monitor your heart
rate in beats per minute (bpm). Your
heart rate intensity is determined using
the following equation: 220 minus your
age (which is your predicted maximum
heart rate), multiplied by a percentage
of how hard you want to work out.

For example, if you are 50 years old
and you want to exercise at a low intensity
(50% to 60% of your predicted maximum
heart rate), the formula would look
like this: 220 – 50 years = 170, multiplied
by 50% (0.5) = 85 bpm; likewise,
60% = 102 bpm. Your goal is to exercise
between 85 bpm and 102 bpm.
You can monitor
your heart
rate using a heart
rate monitor, or
you can count
your heartbeats
for 15 seconds
and multiply that
number by 4 to
get your bpm.
When exercise
at 50% to 60%
(85 to 102 bpm) becomes too easy, increase
your heart rate to a moderate
intensity (65% to 75%; 111 to 128 bpm).

During treatment, you may feel better
on some days and want to exercise at a
moderate intensity, or you may feel poorly
and want to exercise at a lower intensity.
Following treatment, you can steadily
increase either the duration (how long
your workout lasts), the frequency (days
per week), or the intensity (how hard you
work out) of exercise, but progress slowly.
The best rule is to increase duration and
frequency before increasing intensity.

The exercises you do should depend
on where you are in your recovery process.
Walking is always the best activity
to begin your program. Once you are
out of treatment and you feel comfortable
with walking, you may progress to
jogging, cycling, or any activity that uses
large muscle groups.

The Benefits of Weight Training
Weight training is especially beneficial
for cancer survivors. Once your physician
has cleared you, begin strengthening
your upper and lower body. Begin slowly
by using exercise bands two to three
times a day for 10 minutes. Progress to
using free weights for the upper body
while still using the bands for the lower
body. The idea is to progress slowly, especially
with your upper body exercises.

Once you feel strong enough, you
may begin to use stationary machines,
heavier bands, or heavier free weights.
Don’t forget your core. Try sit-ups or
curls on an exercise ball to strengthen
all of the muscles in the abdomen and
back. Cancer survivors must also work
on balance. You can use balance pads,
foam rollers, balance discs, and balance
beams. If you are experiencing lymphedema,
you can still exercise (even
weight training); however, you should
wear a well-fitting compression garment
during exercise.

Your goal for exercise should be to do
a full-body workout (for example, walking,
strength exercises, and balance) two
to three days per week for 45 to 60 minutes
per day. Take control of your life
and make yourself feel better, stronger,
and less anxious with exercise.

♦ ♦ ♦ ♦ ♦

Dr. Carole Schneider is the
founder and director of the Rocky Mountain
Cancer Rehabilitation Institute, which is
located on the campus of the University of
Northern Colorado in Greeley, CO. She is
also a professor in Exercise Physiology at
the university.

This article was published in Coping® with Cancer magazine,
September/October
2011.